AzTrials
AzTrials

Stress, PhysiologicalPECRMNCT05304000

Psychophysiological Effects of Controlled Respiration and Mindfulness

A study testing Mindfulness Meditation, Cyclic Sighing Breathing and Box Breathing in people with Stress, Physiological and Stress, Emotional, run by Stanford University at 2 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The investigators aim to understand the effectiveness of 3 types of breathwork exercises and a mindfulness meditation control on improving psychological and physiological measures of wellbeing. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Stress, Physiological, Stress, Emotional, Insomnia
What is being tested?
Mindfulness Meditation, Cyclic Sighing Breathing and Box Breathing
Could I receive a placebo?
No, everyone receives an active treatment
How many people
108 participants
Where
2 sitesUnited States
Study dates
2 Jun 2020to 17 Sep 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18
  • Not pregnant
  • Able to follow basic instruction for prescreen and scheduling
  • Compliant with investigator instructions during the consent process and participation in the study

Who cannot join

  • Age <18
  • Pregnant
  • Non-English speaking
  • Anyone with personality disorders or psychosis such as schizoaffective disorder
  • Demonstrates evidence of severe psychiatric disorder in prescreen or email contact (as judged by Dr. Spiegel)
  • Glaucoma
Show all 13Show fewer
  • History of seizures
  • Suicidal
  • Heart disease (based on PI's clinical judgement, dependent on the severity of the symptoms)
  • Current untreated psychosis, or bipolar disorder, or substance/alcohol abuse/dependence (based on PI's clinical judgement, dependent on the severity of the symptoms)
  • Any Medical condition that could be exasperated by study participation (based on PI's clinical judgement)
  • Non USA mailing address to receive the WHOOP strap
  • Vision or hearing impairment severe enough to interfere with study participation,

Trial locations and contacts

2 sites in 1 country.

United States2 sites
  • Neurobiology and Ophthalmology

    Palo Alto, California, 94304

  • Dept. of Psychiatry, Stanford University

    Stanford, California, 94305

Other trials in United States

About this study

Official title: Psychophysiological Effects of Controlled Respiration: Noninvasive Relaxation Techniques

The investigators aim to understand the effectiveness of 3 types of breathwork exercises and a mindfulness meditation control on improving psychological and physiological measures of wellbeing. The interventions will be delivered remotely and effects are monitored through daily surveys and physiological monitoring with WHOOP wristband through a 28-day period. The information gained will help develop the most effective remote interventions for lowering stress and improving wellbeing. The study will be run on a healthy general population. The three breathing conditions were 1) Cyclic Sighing, which emphasizes relatively prolonged exhalations, 2) Box Breathing, which is equal duration of inhalations, breath retentions, exhalations and breath retentions, and 3) Cyclic Hyperventilation with Retention, with longer, more intense inhalations and shorter, passive exhalations. Mindfulness Meditation practice involved passive attention to breath.

Read the detailed description

PRIMARY OBJECTIVES:

  1. Examine psychological and physiological effects of breathwork in general in comparison to mindfulness meditation.

SECONDARY OBJECTIVES:

  1. Examine the effectiveness of specific breathwork protocols in improving mood and physiological wellness metrics in comparison to mindfulness meditation.

OUTLINE:

Of 140 potential participants who consented, 134 were randomized to the four interventions (3 were lost to follow-up and 3 were excluded due to lack of WHOOP straps at this stage). Out of the 134 that were randomized, 108 were enrolled. The primary reasons for attrition at this stage were due to pandemic-related reasons or loss of contact with the participants.

From the 108 subjects enrolled, 24 were randomized into the Mindfulness Meditation control condition and 84 were randomized to the treatment conditions (30 Cyclic Sighing, 21 Box Breathing, 33 Cyclic Hyperventilation with Retention). The initial randomization consisted of a permuted block randomization design with a block size of eight.

Both prior to and after the 28-day intervention, participants completed two brief questionnaires to assess the impact of the intervention on the daytime sequelae of sleep and anxiety: PROMIS Sleep Related Impairment - Short Form 8a, and the State-Trait Anxiety Questionnaire. Participants also completed a debriefing questionnaire at the end of the study. During the 28-day intervention period, participants did their assigned 5-minute exercise and completed two questionnaires before and after, the State Anxiety Inventory and the Positive and Negative Affect Schedule (PANAS). Participants received invitations to instructional videos (pre-recorded by Andrew D. Huberman) on the breathing exercises 3-5 days prior to the start of the study as well as daily text messages that reminded them to complete their exercises and pre-and-post-practice assessments. They were asked to complete the exercises only once a day.

Being tested
Mindfulness Meditation, Cyclic Sighing Breathing, Box Breathing, Cyclic Hyperventilation with Retention
Keywords
stress, breathwork, mindfulness meditation, mood, anxiety, wearable, physiology
Medical subject headings
Stress, Psychological, Sleep Initiation and Maintenance Disorders, Anxiety Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Mindfulness MeditationBehavioural

    Participants are informed they should sit down in a chair or, if they preferred, to lie down, and then to set a timer for 5 minutes. Then they are told to close their eyes and to start breathing while focusing their mental attention on their forehead region between their two eyes. They are told that if their focus drifted from that location to re-recenter their attention by focusing back first on their breath and then on the forehead region between their eyes. They are told that as thoughts arise, to recognize that as normal, refocus their attention back to their forehead region and to continue the practice until time has elapsed.

  • Cyclic Sighing BreathingBehavioural

    Participants are informed they should sit down in a chair or, if they prefer, to lie down, and to set a timer for 5 minutes. Then they are told to inhale slowly, and that once their lungs are expanded, to inhale again once more to maximally fill their lungs -- even if the second inhale was shorter in duration and smaller in volume than the first, and then to slowly and fully exhale all their breath. They are told to repeat this pattern of breathing for 5 minutes. They are also informed that ideally, both inhales would be performed via their nose and the exhale would be performed via their mouth, but that if they preferred, they are welcome to do the breathing entirely through their nose. They are also informed that it is normal for the second inhale to be briefer than the first.

  • Box BreathingBehavioural

    Participants are informed they should sit down in a chair or lie down, and to get a timer. Then they are told to take the "CO2 tolerance test" as follows: Take 4 breaths through the nose. Then take a maximally deep breath and once your lungs are full, exhale as slowly as possible through your nose or mouth. Time how long it takes to empty your lungs; this will be your C02 discard duration. Use your discard duration to determine how long your inhales, exhales, and breath holds should be (CO2 discard time) by using this table: <20 sec = 3 - 4 sec, 25 - 45 sec = 5 - 6 sec, 50 - 75+ sec = 8 -10 sec. They are then told to inhale, hold, exhale, hold (for the duration determined by the C02 discard table) and to repeat this pattern for the entire 5 minutes. If at any point they had to strain to reach these times, they should simply reduce the duration of inhales, exhales, and breath holds. We ask participants to perform all breathing through their nose, if possible.

  • Cyclic Hyperventilation with RetentionBehavioural

    Participants are informed they should sit down in a chair or, if they prefer, to lie down, and to set a timer for 5 min. Then they are told to inhale deeply (ideally through their nose but if that is not possible, to inhale through their mouth) and then exhale by passively letting the air "fall out from the mouth". We inform them that for sake of this protocol, that pattern of a deep inhale through the nose and passively letting the air "fall out from the mouth" = 1 breath.

    Then they are instructed to perform 30 breaths (in and out) in this manner, and after those 30 breaths, to exhale all their air via their mouth and to calmly wait with lungs empty for 15 seconds.

Study groups in NCT05304000
Study groupRoleWhat they receive
Mindfulness MeditationActive comparator5 minutes a day of mindfulness meditation practice for 28 days (passive attention to breath) delivered remotely through a video link.
Receives: Behavioral: Mindfulness Meditation
Cyclic Sighing BreathingExperimental5 minutes a day of active breathwork practice for 28 days delivered remotely through a video link. The protocol consists of slow inhales until lungs felt full then one more inhale to maximally fill the lungs, followed up a slow exhale. Repeat this cycle for 5 minutes.
Receives: Behavioral: Cyclic Sighing Breathing
Box BreathingExperimental5 minutes a day of active breathwork practice for 28 days delivered remotely through a video link. The protocol consists of equal duration of inhale, hold, exhale, hold cycles. The duration of the cycle is determined by the participant's comfort level with holding. (e.g. 4 sec inhale, 4 sec hold, 4 sec exhale, 4 sec hold). Repeat this cycle for 5 minutes.
Receives: Behavioral: Box Breathing
Cyclic Hyperventilation with RetentionExperimental5 minutes a day of active breathwork practice for 28 days delivered remotely through a video link. The protocol consists of 30 breaths (inhale deeply through the nose and exhale passively through the mouth) and after those 30 breaths, to exhale all their air via their mouth and to calmly wait with lungs empty for 15 seconds. Repeat this cycle for 5 minutes.
Receives: Behavioral: Cyclic Hyperventilation with Retention

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. State Anxiety

    STAI State Trait Anxiety

    Measured: Daily from Day 0 to 29

  2. Trait Anxiety

    STAI State Trait Anxiety

    Measured: Day 0 and Day 29 (Baseline and Endpoint)

  3. Positive Affect

    PANAS Positive Affect

    Measured: Daily from Day 1 to 28

  4. Negative Affect

    PANAS Negative Affect

    Measured: Daily from Day 1 to 28

  5. Daytime Sleep Related Disturbance

    PROMIS Item Bank v. 1.0 - Sleep-Related Impairment - Short Form 8a PROMIS Item Bank v. 1.0 - Sleep-Related Impairment - Short Form 8a PROMIS Item Bank v. 1.0 - Sleep-Related Impairment - Short Form 8a PROMIS Item Bank v. 1.0 - Sleep-Related Impairment - Short Form 8a PROMIS Item Bank v. 1.0 - Sleep-Related Impairment - Short Form 8a PROMIS Item Bank v. 1.0 - Sleep-Related Impairment - Short Form 8a PROMIS Sleep Related Impairment Short Form 8a

    Measured: Day 0 and Day 29 (Baseline and Endpoint)

  6. Resting Heart Rate

    Daily obtained from WHOOP wrist band

    Measured: Daily from Day 1 to 28

  7. Heart Rate Variability

    Daily obtained from WHOOP wrist band

    Measured: Daily from Day 1 to 28

  8. Respiratory Rate

    Daily obtained from WHOOP wrist band

    Measured: Daily from Day 1 to 28

  9. Sleep Duration

    Daily obtained from WHOOP wrist band

    Measured: Daily from Day 1 to 28

  10. Change in number of hours of sleep

    Daily obtained from WHOOP wrist band as Hours of Sleep. Changes in the hours of sleep will be assessed with more hours indicating better sleep.

    Measured: Daily from Day 1 to 28

  11. Change in the ratio of number of hours of sleep to hours in bed

    Obtained daily from WHOOP wrist band as sleep efficiency. Changes in the Whoop Sleep Efficiency score will be assessed with higher score (ratio) indicating higher sleep efficiency.

    Measured: Daily from Day 1 to 28

Secondary outcomes (1)
  1. Adherence to Protocol

    Number of days subjects did their exercises out of the 28 days assigned

    Measured: Daily from Day 1 to 28

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Mar 2022
  2. Study start2 Jun 2020
  3. Primary completion17 Sep 2020
  4. Study completion17 Sep 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized prospective
Masking
None (open label)
Enrolment
108 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05304000
Sponsor's protocol ID
41398
Acronym
PECRM
Status last verified
May 2022
First submitted
11 Mar 2022
Last updated
6 May 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Mindfulness Meditation, Cyclic Sighing Breathing and Box Breathing in people with Stress, Physiological and Stress, Emotional, run by Stanford University at 2 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 6 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

State Anxiety (time frame: Daily from Day 0 to 29). The study lists 11 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 May 2022.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in